JP2014039809A - Apparatus for endoscope procedure - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electromechanical surgical operation system including a surgical operation instrument held by hands, an end effector, and a shaft assembly for selectively connecting the end effector and the surgical operation device to each other for endoscope procedure.SOLUTION: A shaft assembly 200 is a distal neck housing for connecting a transmission housing 212, an outer tubular body 210, a rotatable driving member of a surgical operation instrument 100 and a rotary receiving member supported in an end effector 400 to each other, which includes at least one gear system configured to convert the rotational input of the rotatable driving member to at least two output forces to the end effector, and includes the distal housing and a neck assembly 230 making a joint motion to connect the tubular body 210 and the distal neck housing to each other. The neck assembly making a joint motion is configured to make a joint motion shifted from the axis of the distal neck assembly.

Description

(Cross-reference to related applications)
This application claims the benefit of and priority to US Provisional Patent Application No. 61 / 673,792, filed July 20, 2012, the entire disclosure of which is hereby incorporated by reference. .

(background)
1. TECHNICAL FIELD The present disclosure relates to surgical apparatus, devices and / or systems for performing endoscopic surgical procedures, and methods of use thereof. More particularly, the present disclosure is configured for use with a removable disposable loading unit and / or a single use loading unit for clamping, cutting and / or stapling tissue, It relates to a selectable gearbox for a hand-held electromechanical surgical apparatus, device and / or system.

2. Background of Related Art Many surgical device manufacturers have developed product lines with dedicated drive systems for operating and / or operating electromechanical surgical devices. Some electromechanical surgical devices include a reusable handle assembly, a replaceable loading unit and / or a single use loading unit, and the like that are selective to the handle assembly prior to use. And then disconnected from the handle assembly after use, for disposal purposes, or in some instances for sterilization for reuse.

  Many of these electromechanical surgical devices can be relatively expensive to manufacture, purchase and / or operate. It is desired by manufacturers and end users to develop electromechanical surgical devices that are relatively inexpensive to manufacture, purchase and / or operate.

  Accordingly, there is a need for electromechanical surgical apparatus, devices and / or systems that are relatively economical to develop and manufacture, store and transport, and that are economical and simple to purchase and use from the end-user perspective. It is said that.

  There is a further need for an electromechanical surgical device for incorporating a gearbox that reduces the number of drive cables extending through the articulating neck assembly.

(wrap up)
The present disclosure relates to a hand-held electrical device configured for use with a removable disposable loading unit and / or a single use loading unit for clamping, cutting and / or stapling tissue. The present invention relates to a selectable gearbox for mechanical surgical apparatus, devices and / or systems.

  In accordance with aspects of the present disclosure, an electromechanical surgical system is provided, the electromechanical surgical system being a hand held surgical instrument, the hand held surgical instrument for selectively connecting with a shaft assembly. A surgical instrument including an instrument housing defining a connecting portion, the surgical instrument having at least one rotatable drive member; an end effector configured to perform at least one function; and an end effector; And a shaft assembly arranged to selectively interconnect with the surgical device.

  The shaft assembly is a transmission housing configured and adapted for selective connection to a connection portion of the surgical device, the transmission housing being each of at least one rotatable drive member of the surgical device. A transmission housing, a proximal end supported by the transmission housing and a distal end configured and adapted for operative connection with the end effector An outer tubular body and a distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotation receiving member supported within the end effector. The distal neck housing includes a first end connectable to one rotatable drive member of the surgical instrument and a second end connectable to the rotation receiving member of the end effector. The force transmission assembly transmits the rotation of the rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. The distal neck assembly includes at least one gear system configured to convert the rotational input of the rotatable drive member into at least two output forces on the end effector. The shaft assembly further includes an articulating neck assembly interconnecting the tubular body and the distal neck housing such that the articulating neck assembly allows articulation off-axis of the distal neck assembly. And a rotatable drive member extends through the articulating neck assembly.

  The force of the first output of the at least one gear system of the distal neck housing can result in firing of the end effector. The first output force of the at least one gear system of the distal neck housing may result in rotation of the end effector relative to the shaft assembly.

  The distal neck housing may non-rotatably and slidably support the locking collar gear, and the locking collar gear may cause the first output force of at least one gear system of the distal neck housing to cause the end effector to fire. The first output force of the at least one gear system of the distal neck housing, including the first position, results in rotation of the end effector relative to the shaft assembly.

  The distal neck housing is an outer tubular housing that defines at least one tooth extending radially inward from the outer tubular housing, and a first gear system supported within the outer tubular housing; Can be included. The first gear system includes a first sun gear that is drivable by one rotatable drive member of the surgical instrument, a ring gear that is rotatably supported in the outer tubular housing, and a first sun gear. And at least one first planetary gear disposed between the first and second ring gears and interengaging the first sun gear and the ring gear, and a carrier rotatably supported in the outer tubular housing. The carrier may include a respective stem that rotatably supports each first planetary gear. In use, the end effector can be fired when the first sun gear rotates each first planetary gear about the axis of rotation of the first sun gear. Also, in use, the end effector can be rotated when the first sun gear rotates each first planetary gear about its respective axis of rotation.

  The distal neck housing may include a crown gear non-rotatably connected to the carrier and a locking collar gear supported within the outer tubular housing that is non-rotatable and slidable relative to the shaft. The lock collar gear may include a first position where the lock collar gear engages the crown gear and prevents the crown gear from rotating, and the non-rotation of the crown gear allows the end effector to rotate. The lock collar gear may include a second position that allows the lock collar gear to disengage from the crown gear and allow the crown gear to rotate, the rotation of the crown gear allowing the end effector to fire.

  The distal neck housing includes a rotating hub non-rotatably supported within the outer tubular housing and a second gear system supported within the rotating hub. The second gear system includes a second sun gear non-rotatably connected to the carrier and at least one second gear rotatably supported in the rotating hub and interengaged with the second sun gear. A launch connector connected to a planetary gear and one of at least one second planetary gear, the launch connector configured to engage a force receiving member of an end effector Can be included. In use, as the carrier rotates, the second sun gear can be rotated to rotate the at least one second planetary gear and fire the end effector.

  The distal neck housing may include a first clutch mechanism that is positioned between the lock collar gear and the crown gear when the lock collar gear is in the first position, And the crown gear are interconnected. The distal neck housing may include a second clutch mechanism that is positioned between the lock collar gear and the first ring gear when the lock collar gear is in the second position; The lock collar gear and the first ring gear are interconnected. At least one of the first clutch mechanism and the second clutch mechanism are frictions disposed between the lock collar gear and the crown gear and between the lock collar gear and the first ring gear, respectively. A reinforcing material may be included.

  The hand-held surgical instrument is at least one drive motor supported within the instrument housing, wherein the at least one drive motor is configured to rotate at least one rotatable drive member, at least One drive motor, a battery disposed in the instrument housing to supply power to the at least one drive motor, and a circuit board disposed in the instrument housing to control power delivered from the battery to the motor And may further include.

  The end effector may include an upper jaw and a lower jaw, and at least one of the upper jaw and the lower jaw is movable relative to the other of the upper jaw and the lower jaw.

  The electromechanical surgical system may further include at least one surgical buttress releasably secured to at least one tissue contacting surface of the upper and lower jaws.

  The electromechanical surgical system may further include a drive beam that is translatable through at least one of the upper jaw and the lower jaw to move the lower jaw relative to the upper jaw.

  The end effector includes an upper jaw and a lower jaw, and at least one of the upper jaw and the lower jaw is movable with respect to the other of the upper jaw and the lower jaw, and the cartridge assembly supported in the lower jaw The cartridge assembly includes a plurality of staples therein and at least one surgical buttress releasably secured to the tissue contacting surface of at least one of the upper and lower jaws; The at least one surgical buttress is secured to at least one of the upper and lower jaws by at least one suture, and at least one of the upper and lower jaws is configured to receive a portion of the at least one suture. And at least one surgical buttress.

  The lower jaw of the end effector may be configured to selectively receive the cartridge assembly. The cartridge assembly includes a cartridge body defining a longitudinally extending knife slot and a plurality of staples disposed within individual staple holding slots formed within the cartridge body, wherein the staple holding slot is opposite the knife slot. A plurality of staples disposed in a plurality of longitudinally extending rows disposed on a side surface and an activation sled supported slidably within the cartridge body, wherein the activation sled is from a proximal position Slidable into the cartridge body at a location proximal to the activation sled and configured to release at least a portion of the plurality of staples from the cartridge body upon distal movement of the activation sled A knife sled supported by the knife sled, the knife sled extending into the knife slot Including blades, it may include a knife sled. In use, the drive beam may engage the knife sled and the activation sled when the cartridge assembly is positioned within the lower jaw and the drive beam is advanced.

  The activation sled of the cartridge assembly may remain in a position advanced distally after any retraction of the drive beam.

  The knife sled of the cartridge assembly may include a lockout spring extending from the knife sled, which locks the knife sled forward by engaging a lockout cutout defined in the cartridge body. Stop.

  In use, if the activation sled and knife sled are in the proximal position, the activation sled may interfere with the engagement of the knife sled lockout spring with the lockout notch in the cartridge body.

  The knife sled of the cartridge assembly can be retracted upon any retraction of the drive beam. The drive beam may include a lock clip extending from the drive beam, the lock clip of the drive beam having a knife upon any distal advancement of the drive beam such that the knife sled is retracted upon retraction of the drive beam. Engage the sled.

  The at least one rotation receiving member of the end effector may include a drive screw rotatably supported in the lower jaw, and the drive beam may be threadably supported on the drive screw so that rotation of the drive screw is Provides axial translation of the drive beam.

  The at least one rotation receiving member of the end effector may include a drive screw rotatably supported in the lower jaw, and the drive beam may be threadably supported on the drive screw so that rotation of the drive screw is Provides axial translation of the drive beam.

  The at least one force transmission assembly of the shaft assembly may include a first gear train system that interconnects at least one rotatable drive member of the surgical instrument and at least one rotation receiving member of the end effector. The first gear train system includes a speed of rotation between at least one rotatable drive member of the surgical instrument and at least one rotation receiving member of the end effector, and at least one rotatable drive of the surgical instrument. Changing at least one of the axes of rotation between the member and at least one rotation receiving member of the end effector.

  The shaft assembly can include an articulating neck assembly, and the first gear train system is disposed proximal to the articulating neck assembly.

  The shaft assembly may include a neck housing disposed distal to the articulating neck assembly. The distal neck housing may support the neck first gear train of at least one force transmission assembly. The neck first gear train may interconnect the output of the first gear train system with at least one rotation receiving member of the end effector. In use, the neck first gear train includes a speed of rotation between the output of the first gear train system and at least one rotation receiving member of the end effector, and the output of the first gear train system and the end effector. At least one of the axes of rotation between the at least one rotation receiving member may be changed.

  At least one rotation receiving member of the end effector may include a drive screw rotatably supported in the lower jaw. The drive beam can be threadably supported on the drive screw so that rotation of the drive screw results in axial translation of the drive beam.

  At least one rotation receiving member of the end effector may include a drive screw rotatably supported in the lower jaw. The drive beam can be threadably supported on the drive screw so that rotation of the drive screw results in axial translation of the drive beam.

  At least one force transmission assembly of the shaft assembly interconnects another of the at least one rotatable drive member of the surgical instrument and a rotating hub rotatably supported at the distal end of the neck housing. A second gear train system may be included. In use, the second gear train system provides a speed of rotation between another at least one rotatable drive member of the surgical instrument and a rotating hub of the shaft assembly, and another at least one rotation of the surgical instrument. At least one of the axes of rotation between the possible drive member and the rotating hub of the shaft assembly may be changed.

  The shaft assembly extends at least partially along the neck assembly, an articulating neck assembly supported at the distal end of the outer tube, a distal neck housing supported at the distal end of the articulating neck assembly. First and second diametrically opposed articulation cables, each articulation cable having a distal end anchored to the distal neck housing and a proximal end extending into the outer tube. The proximal end of each articulation cable is secured to a respective first and second rack, each rack being operatively connected to each other by a spur gear.

  The axial displacement of the first rack in the first direction is the axial displacement of the first articulation cable in the first direction and the joint of the neck assembly in the direction offset from the first axis. Movement and axial displacement of the second articulation cable in a direction opposite to the first direction may be provided.

  The shaft assembly may further include a threaded rod extending proximally from the first rack and a threaded shaft threadably connected to the threaded rod extending from the first rack. The shaft is connected to at least one other drive member of the surgical instrument. In use, rotation of at least one other drive member of the surgical instrument imparts rotation to the threaded shaft, which in turn provides axial displacement of the threaded rod and the first rack.

  The shaft assembly is an articulating neck assembly supported at the distal end of the outer tube, the neck assembly defining a central axis and articulating in a first plane; A distal neck housing supported at a distal end of the moving neck assembly; first and second diametrically opposed articulation cables extending at least partially along the neck assembly; and at least along the neck assembly A first drive cable that defines a first drive shaft that extends partially and is radially spaced from a central axis, the first drive shaft extending perpendicular to the first surface. A first drive cable defined by the first drive surface and extending at least partially along the neck assembly and radially from the central axis A second drive cable defining a second drive shaft spaced apart, wherein the second drive shaft is defined by a second drive surface extending orthogonally to the first surface; And two drive cables. The first drive cable and the second drive cable may diametrically oppose each other.

  In accordance with another aspect of the present disclosure, an electromechanical surgical system is provided. The electromechanical surgical system includes a hand-held surgical instrument, the hand-held surgical instrument includes an instrument housing defining a connection portion for selective connection with the shaft assembly, the surgical instrument comprising at least It has one rotatable drive member. The electromechanical surgical system includes an end effector configured to perform at least one function. The shaft assembly is positioned to selectively interconnect the end effector and the surgical device.

  The shaft assembly is a transmission housing configured and adapted for selective connection to a connection portion of the surgical device, the transmission housing being each of at least one rotatable drive member of the surgical device. A transmission housing, a proximal end supported by the transmission housing and a distal end configured and adapted for operative connection with the end effector An outer tubular body, and a distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotation receiving member supported within the end effector, the distal neck housing comprising: Can be connected to one rotatable drive member A force transmission assembly includes a first end and a second end connectable to the end effector's rotation receiving member, and the force transmission assembly transmits rotation of the rotatable drive member of the surgical instrument to the end effector's rotation receiving member. introduce.

  The distal neck housing is an outer tubular housing that defines at least one tooth extending radially inward from the outer tubular housing, and a first gear system supported within the outer tubular housing; including. The first gear system includes a first sun gear that is drivable by one rotatable drive member of the surgical instrument, a ring gear that is rotatably supported in the outer tubular housing, and a first sun gear. And at least one first planetary gear disposed between the first and second ring gears and interengaging the first sun gear and the ring gear, and a carrier rotatably supported in the outer tubular housing. The carrier includes a respective stem that rotatably supports each first planetary gear.

  In accordance with an aspect of the present disclosure, in one mode of operation, when the first sun gear is rotated, each first planetary gear is turned about the central axis of the first sun gear to fire the end effector. Bring. Also, according to aspects of the present disclosure, in a different mode of operation, when the first sun gear is rotated, each first planetary gear is rotated about the respective axis of rotation of each first planetary gear. , Causing rotation of the end effector.

  The distal neck assembly includes a crown gear that is non-rotatably connected to the carrier and a lock pin that is non-rotatably and slidably supported within the outer tubular housing relative to the shaft. The lock pin includes a first position where the lock pin engages the crown gear and prevents the crown gear from rotating, non-rotation of the crown gear allows rotation of the end effector, and the lock pin locks The pin is disengaged from the crown gear and includes a second position that allows the crown gear to rotate, the rotation of the crown gear allowing the end effector to fire.

For example, the present invention provides the following items.
(Item 1)
An electromechanical surgical system, the electromechanical surgical system comprising:
A hand-held surgical instrument including an instrument housing defining a connection portion for selective connection with a shaft assembly, the surgical instrument having at least one rotatable drive member; ,
An end effector configured to perform at least one function;
The shaft assembly disposed to selectively interconnect the end effector and the surgical instrument, the shaft assembly comprising:
A transmission housing configured and adapted for selective connection to the connection portion of the surgical instrument, the transmission housing being one of the at least one rotatable drive member of the surgical instrument. A transmission housing configured and adapted to be in operative communication with each other;
An outer tubular body having a proximal end supported by the transmission housing and a distal end configured and adapted for operative connection with the end effector;
A distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotary receiving member supported within the end effector, the distal neck housing being one of the surgical instrument. A force transmission assembly including a first end connectable to one rotatable drive member and a second end connectable to the rotation receiving member of the end effector. Transmitting possible drive member rotation to the rotation receiving member of the end effector, the distal neck housing comprising:
Including at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces on the end effector;
A distal neck housing;
An articulating neck assembly interconnecting the tubular body and the distal neck housing, wherein the articulating neck assembly allows articulation off-axis of the distal neck housing An electromechanical surgical system, wherein the rotatable drive member includes an articulating neck assembly extending through the articulating neck assembly.
(Item 2)
The electromechanical surgical system of any preceding item, wherein the first output force of the at least one gear system of the distal neck housing results in firing of the end effector.
(Item 3)
The electromechanical surgical system of any of the preceding items, wherein a first output force of the at least one gear system of the distal neck housing results in rotation of the end effector relative to the shaft assembly. .
(Item 4)
The distal neck housing supports a locking collar gear in a non-rotatable and slidable manner, and the locking collar gear receives the first output force of the at least one gear system of the distal neck housing from the end. Wherein the first output force of the at least one gear system of the distal neck housing results in rotation of the end effector relative to the shaft assembly. The electromechanical surgical operation system according to any one of the above.
(Item 5)
The distal neck housing is
An outer tubular housing defining at least one tooth extending radially inward from the outer tubular housing;
A first gear system supported within the outer tubular housing, the first gear system comprising:
A first sun gear that is drivable by the one rotatable drive member of the surgical instrument;
A ring gear rotatably supported in the outer tubular housing;
At least one first planetary gear positioned between the first sun gear and the ring gear and interengaging the first sun gear and the ring gear;
A carrier rotatably supported within the outer tubular housing, the carrier comprising:
Including a respective stem rotatably supporting each first planetary gear;
In one mode of operation, when the first sun gear is rotated, each first planetary gear is turned around the central axis of the first sun gear, resulting in the firing of the end effector,
In another mode of operation, when the first sun gear is rotated, each first planetary gear is rotated about the respective axis of rotation of each first planetary gear, and the rotation of the end effector Bring the
The electromechanical surgical operation system according to any one of the above items.
(Item 6)
The distal neck housing is
A crown gear non-rotatably connected to the carrier;
A locking collar gear supported within the outer tubular housing in a non-rotatable and slidable manner with respect to the shaft;
The lock collar gear includes a first position where the lock collar gear engages the crown gear and prevents the crown gear from rotating; non-rotation of the crown gear prevents rotation of the end effector. Enable
The locking collar gear includes a second position that allows the locking collar gear to be disengaged from the crown gear and allowing the crown gear to rotate, the rotation of the crown gear being the firing of the end effector. Enable,
The electromechanical surgical operation system according to any one of the above items.
(Item 7)
The distal neck housing is
A rotating hub non-rotatably supported in the outer tubular housing;
A second gear system supported in the rotating hub, the second gear system comprising:
A second sun gear non-rotatably connected to the carrier;
At least one second planetary gear rotatably supported in the rotating hub and interengaged with the second sun gear;
A firing connector connected to one of the at least one second planetary gear, the firing connector configured to engage a force receiving member of the end effector; Including
When the carrier rotates, the second sun gear is rotated to rotate the at least one second planetary gear to fire the end effector.
The electromechanical surgical operation system according to any one of the above items.
(Item 8)
The distal neck housing includes a first clutch mechanism that is disposed between the lock collar gear and the crown gear when the lock collar gear is in the first position. The electromechanical surgical system according to any one of the preceding items, wherein the lock collar gear and the crown gear are interconnected.
(Item 9)
The distal neck housing includes a second clutch mechanism, the second clutch mechanism including a lock collar gear and the first ring gear when the lock collar gear is in the second position. The electromechanical surgical system according to any one of the preceding items, interposed between and interconnecting the locking collar gear and the first ring gear.
(Item 10)
At least one of the first clutch mechanism and the second clutch mechanism is disposed between the lock collar gear and the crown gear and between the lock collar gear and the first ring gear, respectively. An electromechanical surgical system according to any one of the preceding items, comprising a friction enhancing material.
(Item 11)
Surgical instruments held by the hand
At least one drive motor supported within the instrument housing, wherein the at least one drive motor is configured to rotate the at least one rotatable drive member; ,
A battery disposed within the instrument housing to supply power to the at least one drive motor;
The electromechanical surgical system according to any one of the preceding items, further comprising: a circuit board disposed within the instrument housing to control power delivered from the battery to the motor.
(Item 12)
The end effector is
An upper jaw and a lower jaw, wherein at least one of the upper jaw and the lower jaw is movable with respect to the other of the upper jaw and the lower jaw.
The electromechanical surgical operation system according to any one of the above items.
(Item 13)
The electromechanical surgical system according to any one of the preceding items, further comprising at least one surgical buttress releasably secured to at least one tissue contacting surface of the upper jaw and the lower jaw.
(Item 14)
The electrical machine of any one of the preceding items, further comprising a drive beam translatable through at least one of the upper jaw and the lower jaw to move the lower jaw relative to the upper jaw. Surgical system.
(Item 15)
The end effector is
An upper jaw and a lower jaw, wherein at least one of the upper jaw and the lower jaw is movable relative to the other of the upper jaw and the lower jaw; and
A cartridge assembly supported within the lower jaw, the cartridge assembly including a plurality of staples therein;
At least one surgical buttress releasably secured to a tissue contacting surface of at least one of the upper jaw and the lower jaw, wherein the at least one surgical buttress is coupled to the upper jaw and the At least one surgical buttress secured to the at least one of the lower jaws, the upper jaw and the at least one of the lower jaws configured to receive a portion of the at least one suture; An electromechanical surgical system according to any one of the preceding items comprising:
(Item 16)
The lower jaw of the end effector is configured to selectively receive a cartridge assembly, the cartridge assembly comprising:
A cartridge body defining a longitudinally extending knife slot;
A plurality of staples disposed within individual staple retaining slots formed within the cartridge body, wherein the staple retaining slots are a plurality of longitudinally extending rows disposed on opposite sides of the knife slot. A plurality of staples disposed in the
An activation sled slidably supported within the cartridge body, the activation sled being at least one of the plurality of staples from the cartridge body upon distal movement of the activation sled from a proximal position; An activation sled configured to discharge a portion;
A knife sled slidably supported within the cartridge body at a location proximal to the activation sled, the knife sled comprising a knife blade extending into the knife slot;
The drive beam engages the knife sled and the activation sled when the cartridge assembly is disposed in the lower jaw and the drive beam is advanced.
The electromechanical surgical operation system according to any one of the above items.
(Item 17)
The electromechanical surgical system of any of the preceding items, wherein the activation sled of the cartridge assembly remains in a distally advanced position after any retraction of the drive beam.
(Item 18)
The knife sled of the cartridge assembly includes a lockout spring extending from the knife sled, and the lockout spring of the knife sled engages a lockout cutout defined in the cartridge body. The electromechanical surgical system according to any one of the preceding items, wherein the advancement of the knife sled is prevented.
(Item 19)
Of the above items, wherein the activation sled and the knife sled are in a proximal position, the activation sled obstructs the engagement of the lockout spring of the knife sled with the lockout notch of the cartridge body. The electromechanical surgical operation system according to any one of the above.
(Item 20)
The electromechanical surgical system according to any one of the preceding items, wherein the knife sled of the cartridge assembly is retracted upon every retraction of the drive beam.
(Item 21)
The drive beam includes a lock clip extending from the drive beam, the lock clip of the drive beam extending in all distal directions of the drive beam such that the knife sled is retracted upon retraction of the drive beam. An electromechanical surgical system according to any one of the preceding items, wherein the knife sled is engaged during the advancement.
(Item 22)
The at least one rotation receiving member of the end effector includes a drive screw rotatably supported in the lower jaw, and the drive beam is rotatably supported by the drive screw, whereby the drive screw An electromechanical surgical system according to any one of the preceding items, wherein rotation of the axis results in axial translation of the drive beam.
(Item 23)
The at least one rotation receiving member of the end effector includes a drive screw rotatably supported in the lower jaw, and the drive beam is rotatably supported by the drive screw, whereby the drive screw An electromechanical surgical system according to any one of the preceding items, wherein rotation of the axis results in axial translation of the drive beam.
(Item 24)
The at least one force transmission assembly of the shaft assembly includes a first gear train system interconnecting the at least one rotatable drive member of the surgical instrument and the at least one rotation receiving member of the end effector. The first gear train system comprises:
The speed of rotation between the at least one rotatable drive member of the surgical instrument and the at least one rotation receiving member of the end effector; and the at least one rotatable drive member of the surgical instrument; The electromechanical surgical system according to any one of the preceding items, wherein at least one of the axes of rotation between the end effector and the at least one rotation receiving member is changed.
(Item 25)
The electrical shaft of any of the preceding items, wherein the shaft assembly includes an articulating neck assembly and the first gear train system is disposed proximal to the articulating neck assembly. Mechanical surgical system.
(Item 26)
The shaft assembly includes a neck housing disposed distal to the articulating neck assembly, the distal neck housing supporting a neck first gear train of the at least one force transmission assembly, the neck assembly A first gear train interconnects the output of the first gear train system with the at least one rotation receiving member of the end effector, the neck first gear train comprising:
The speed of rotation between the output of the first gear train system and the at least one rotation receiving member of the end effector; and the output of the first gear train system and the at least one of the end effector The electromechanical surgical system according to any one of the preceding items, wherein at least one of the axes of rotation with the rotation receiving member is changed.
(Item 27)
The at least one rotation receiving member of the end effector includes a drive screw rotatably supported in the lower jaw, and the drive beam is rotatably supported by the drive screw, whereby the drive screw An electromechanical surgical system according to any one of the preceding items, wherein rotation of the axis results in axial translation of the drive beam.
(Item 28)
The at least one rotation receiving member of the end effector includes a drive screw rotatably supported in the lower jaw, and the drive beam is rotatably supported by the drive screw, whereby the drive screw An electromechanical surgical system according to any one of the preceding items, wherein rotation of the axis results in axial translation of the drive beam.
(Item 29)
The at least one force transmission assembly of the shaft assembly includes another one of the at least one rotatable drive member of the surgical instrument and a rotatably supported rotation at the distal end of the neck housing. A second gear train system interconnecting with the hub, the second gear train system comprising:
The speed of rotation between the at least one rotatable drive member of the surgical instrument and the rotating hub of the shaft assembly; and the at least one rotatable drive member of the surgical instrument; The electromechanical surgical system according to any one of the preceding items, wherein at least one of the axes of rotation of the shaft assembly with the rotating hub is altered.
(Item 30)
The shaft assembly is
An articulating neck assembly supported at the distal end of the outer tube;
A distal neck housing supported at the distal end of the articulating neck assembly;
And first and second diametrically opposed articulation cables extending at least partially along the neck assembly;
Each articulation cable includes a distal end anchored to the distal neck housing and a proximal end extending into the outer tube, the proximal end of each articulation cable having a respective first and Fixed to the second rack, each rack is operatively connected to each other by a spur gear;
The axial displacement of the first rack in the first direction is
An axial displacement of the first articulation cable in the first direction;
Articulation of the neck assembly in a direction offset from the first axis;
An electromechanical surgical system according to any one of the preceding items, providing an axial displacement of the second articulation cable in a direction opposite to the first direction.
(Item 31)
The shaft assembly is
A threaded rod extending proximally from the first rack;
A threaded shaft threadably connected to the threaded rod extending from the first rack, the threaded shaft connected to at least one other drive member of the surgical instrument. And
Rotating the at least one drive member of the surgical instrument imparts rotation to the threaded shaft, which in turn provides axial displacement of the threaded rod and first rack. An electromechanical surgical system according to any one of the preceding claims.
(Item 32)
The shaft assembly is
An articulating neck assembly supported at a distal end of the outer tube, the neck assembly defining a central axis and articulating in a first plane;
A distal neck housing supported at the distal end of the articulating neck assembly;
First and second diametrically opposed articulation cables extending at least partially along the neck assembly;
A first drive cable defining a first drive shaft extending at least partially along the neck assembly and radially spaced from the central axis, the first drive shaft comprising: A first drive cable defined by a first drive surface extending perpendicular to the first surface;
A second drive cable defining a second drive shaft extending at least partially along the neck assembly and radially spaced from the central axis, the second drive shaft comprising: A second drive cable defined by a second drive surface extending orthogonal to the first surface; and
The first drive cable and the second drive cable are diametrically opposed to each other;
The electromechanical surgical operation system according to any one of the above items.
(Item 33)
Electromechanical surgical system
A hand-held surgical instrument, the hand-held surgical instrument includes an instrument housing defining a connection portion for selective connection with a shaft assembly, the surgical instrument being at least one rotatable A surgical instrument having a suitable drive member;
An end effector configured to perform at least one function;
The shaft assembly disposed to selectively interconnect the end effector and a surgical device, the shaft assembly comprising:
A transmission housing configured and adapted for selective connection to the connection portion of the surgical device, the transmission housing being one of the at least one rotatable drive member of the surgical device. A transmission housing configured and adapted to be in operative communication with each other;
An outer tubular body having a proximal end supported by the transmission housing and a distal end configured and adapted for operative connection with the end effector;
A distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotary receiving member supported within the end effector, the distal neck housing being one of the surgical instrument. A force transmission assembly including a first end connectable to one rotatable drive member and a second end connectable to the rotation receiving member of the end effector. Transmitting possible drive member rotation to the rotation receiving member of the end effector, the distal neck assembly comprising:
An outer tubular housing defining at least one tooth extending radially inward from the outer tubular housing;
A first gear system supported within the outer tubular housing, the first gear system comprising:
A first sun gear that is drivable by the one rotatable drive member of the surgical instrument;
A ring gear rotatably supported in the outer tubular housing;
At least one first planetary gear positioned between the first sun gear and the ring gear and interengaging the first sun gear and the ring gear;
A carrier rotatably supported within the outer tubular housing, the carrier including a respective stem rotatably supporting each first planetary gear;
When the first sun gear rotates each first planetary gear about the axis of rotation of the first sun gear, the end effector is fired,
When the first sun gear rotates each first planetary gear about its respective axis of rotation, the end effector is rotated,
A first gear system;
A crown gear non-rotatably connected to the carrier;
A locking pin supported in the outer tubular housing in a non-rotatable and slidable manner relative to a shaft,
The lock pin includes a first position where the lock pin engages the crown gear and prevents the crown gear from rotating; non-rotation of the crown gear allows rotation of the end effector. ,
The lock pin includes a second position that allows the lock pin to disengage from the crown gear and allow the crown gear to rotate, the rotation of the crown gear allowing the end effector to fire. An electromechanical surgical system including a locking pin and a distal neck housing.
(Item 34)
The electromechanical surgery of any of the preceding items, wherein the shaft assembly is configured to convert a rotational input of the rotatable drive member into at least two output forces on the end effector. Surgery system.
(Item 35)
The shaft assembly is
And further including an articulating neck assembly interconnecting the tubular body and the distal neck housing, the articulating neck assembly to allow articulation off-axis of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly,
The electromechanical surgical operation system according to any one of the above items.
(Item 36)
The distal neck housing is
A rotating hub non-rotatably supported in the outer tubular housing;
A second gear system supported within the rotating hub, the second gear system comprising:
A second sun gear non-rotatably connected to the carrier;
At least one second planetary gear rotatably supported in the rotating hub and interengaged with the second sun gear;
A firing connector connected to one of the at least one second planetary gear, the firing connector configured to engage a force receiving member of the end effector; and Any one of the preceding items, wherein when the carrier rotates, the second sun gear is rotated to rotate the at least one second planetary gear to fire the end effector. The electromechanical surgical system according to claim 1.
(Item 37)
Surgical instruments held by the hand
At least one drive motor supported within the instrument housing, wherein the at least one drive motor is configured to rotate the at least one rotatable drive member; ,
A battery disposed within the instrument housing to supply power to the at least one drive motor;
The electromechanical surgical system according to any one of the preceding items, further comprising: a circuit board disposed within the instrument housing to control power delivered from the battery to the motor.

(Summary)
An electromechanical surgical system is provided that includes a hand-held surgical instrument, an end effector, and a shaft assembly for selectively interconnecting the end effector and the surgical device. The shaft assembly is a distal neck housing for interconnecting a transmission housing, an outer tubular body, a rotatable drive member of a surgical instrument, and a rotation receiving member supported within the end effector, The neck housing includes at least one gear system configured to convert the rotational input of the rotatable drive member into at least two output forces on the end effector, the distal neck housing, the tubular body, and the distal An articulating neck assembly interconnecting the neck housing. The articulating neck assembly is configured to allow articulation off-axis of the distal neck assembly, and the rotatable drive member extends through the articulating neck assembly.

  Further details and aspects of exemplary embodiments of the invention are described in more detail below with reference to the accompanying drawings.

  Embodiments of the present disclosure are described herein with reference to the accompanying drawings.

FIG. 1 is a perspective view of an electromechanical surgical system according to one embodiment of the present disclosure. FIG. 2 is a perspective view of the electromechanical surgical system of FIG. 1 with parts separated. FIG. 3 is a rear perspective view illustrating the connection between the shaft assembly and power surgical instrument of the electromechanical surgical system of FIGS. 1 and 2. FIG. 4 is a perspective view of the shaft assembly of FIGS. 1 to 3 with parts separated. FIG. 5 is a perspective view of the transmission housing of the shaft assembly with parts separated. FIG. 6 is a perspective view of a first gear train system supported within the transmission housing. FIG. 7 is a perspective view of a second gear train system supported within the transmission housing. FIG. 8 is a perspective view of a third drive shaft supported within the transmission housing. FIG. 9 is a perspective view of the neck assembly of the shaft assembly, shown in a straight orientation. 10 is a perspective view of the neck assembly of FIG. 9 shown in an articulated state. FIG. 11 is a perspective view of the neck assembly of FIGS. 9 and 10 with the threaded nut separated. FIG. 12 is a perspective view of the neck assembly of FIGS. 9-11 with parts separated. 13 is a cross-sectional view of the neck assembly of FIGS. 9-12, viewed through 13-13 of FIG. FIG. 14 is an enlarged distal perspective view of the distal neck housing of the neck assembly of FIGS. 9-12. FIG. 15 is an enlarged proximal perspective view of the distal neck housing of FIG. FIG. 16 is a perspective view of the distal neck housing of FIGS. 14 and 15 with parts separated. FIG. 17 is a perspective view of the distal neck housing of FIGS. 14-16 with the outer tubular housing removed therefrom. 18 is a perspective view of the distal neck housing of FIGS. 14-16 with the outer tubular housing removed therefrom. 19 is a cross-sectional view of the distal neck housing as viewed through 19-19 of FIG. 20 is a cross-sectional view of the distal neck housing as viewed through 20-20 of FIG. 21 is a cross-sectional view of the distal neck housing as viewed through 21-21 of FIG. 22 is a cross-sectional view of the distal neck housing taken through 22-22 of FIG. 15, illustrating the distal neck housing in a rotational configuration. 23 is a cross-sectional view of the distal neck housing, viewed through 23-23 of FIG. 15, illustrating the distal neck housing in a rotational configuration. 24 is an enlarged view of the area of detail shown in FIG. FIG. 25 is a cross-sectional view of the distal neck housing as viewed through 22-22 of FIG. 15, illustrating the distal neck housing in a firing configuration. FIG. 26 is an enlarged view of the area of detail shown in FIG. 27 is a perspective view illustrating the connection of the end effector to the distal neck housing of FIGS. FIG. 28 is a perspective view illustrating the connection of the end effector to the distal neck housing of FIGS. FIG. 29 is a perspective view illustrating the connection of the end effector to the distal neck housing of FIGS. 30 is a cross-sectional view of the end effector taken through 30-30 of FIG. 31 is a cross-sectional view through 22-22 of FIG. 15 of a distal neck housing according to another embodiment of the present disclosure, illustrating a crown gear and a lock collar gear according to another embodiment of the present disclosure. doing. 32 is an enlarged view of the area of detail shown in FIG. 33 is a front perspective view of the crown gear of FIGS. 31 and 32. FIG. FIG. 34 is an enlarged view of the area of detail shown in FIG. FIG. 35 is a rear perspective view of the crown gear of FIGS. 31 and 32. 36 is a cross-sectional view taken along line 36-36 in FIG. FIG. 37 is a rear perspective view of a distal neck housing according to yet another embodiment of the present disclosure. 38 is a top perspective view of the locking pin of the distal neck housing of FIG. 39 is a cross-sectional view of the distal neck housing of FIGS. 37 and 38, viewed through 39-39 of FIG. 40 is an enlarged view of the area of detail shown in FIG. 41 is a cross-sectional view of the distal neck housing of FIGS. 37 and 38, taken through 39-39 of FIG. 37, with components removed therefrom. 42 is a plan view of the distal neck housing of FIG. 41. FIG. 43 is an enlarged view of the area of detail shown in FIG.

(Detailed description of embodiment)
Embodiments of the electromechanical surgical system, apparatus and / or device of the present disclosure will be described in detail with reference to the drawings, wherein like reference numerals designate like elements or corresponding parts in each of the several views. Represents the element to be As used herein, the term “distal” refers to the portion of an electromechanical surgical system, apparatus and / or device, or component thereof, that is remote from the user, The term “proximal” refers to the portion of an electromechanical surgical system, apparatus and / or device, or component thereof, that is closer to the user.

  Referring initially to FIGS. 1-3, a powered hand-held electromechanical surgical system according to one embodiment of the present disclosure is illustrated and generally designated 10. The electromechanical surgical system 10 comprises a surgical apparatus or device in the form of a powered hand-held electromechanical surgical instrument 100, which is selectively coupled via a shaft assembly 200 of a plurality of different end effectors 400. Configured for attachment, each configured for activation and operation by an electromechanical surgical instrument 100 with a powered hand. Specifically, the surgical instrument 100 is configured for selective connection with the shaft assembly 200, which is then selectively connected to any one of a plurality of different end effectors 400. Configured for secure connection.

  International Application No. PCT / US2008 / 077249 (filed September 22, 2008) (WO 2009/039506) and US Patent Application No. 12 / 622,827 (filed November 20, 2009) (each of these The entire contents of which are hereby incorporated by reference) may be referred to for a detailed description of the construction and operation of an exemplary hand-powered electromechanical surgical instrument 100.

  In general, as illustrated in FIGS. 1 to 3, the surgical instrument 100 includes an instrument housing 102 that extends from the lower housing portion 104, the lower housing portion 104, and / or to the lower housing portion 104. A supported intermediate housing portion 106 and an upper housing portion 108 extending from and / or supported by the intermediate housing portion 106. Surgical instrument 100 has a controller for controlling certain functions of the surgical system, for collecting data, and for performing other functions. The instrument housing 102 defines a cavity in which a circuit board (not shown) and a drive mechanism (not shown) are installed.

  The circuit board is configured to control various operations of the surgical instrument 100, as described in more detail below. According to the present disclosure, the instrument housing 102 provides a housing in which a rechargeable battery (not shown) is removably installed. This battery is configured to provide power to any of the electrical components of surgical instrument 100.

  The upper housing portion 108 of the instrument housing 102 defines a nose or connecting portion 108 a that is configured to receive a corresponding shaft coupling assembly 214 of the transmission housing 212 of the shaft assembly 200. As can be seen in FIG. 3, the connecting portion 108 a of the upper housing portion 108 of the surgical instrument 100 has a cylindrical recess 108 b that fits into the surgical instrument 100. And receives the shaft coupling assembly 214 of the transmission housing 212 of the shaft assembly 200. The connecting portion 108a of the surgical instrument 100 has at least one rotatable drive member. Specifically, the connecting portion 108a houses three rotatable drive members or connectors 118, 120, 122, each drive member or connector being driven by a drive mechanism (not shown) housed in the instrument housing 102. It can be activated independently and rotated.

  The upper housing portion 108 of the instrument housing 102 provides a housing in which a drive mechanism (not shown) is installed. This drive mechanism is configured to drive the shaft and / or gear components for the purpose of performing various operations of the surgical instrument 100. Specifically, the drive mechanism selectively moves the end effector 400 relative to the shaft assembly 200; the anvil assembly and / or the end effector 400 with the longitudinal axis “X” (see FIGS. 1 and 2). Rotation of the anvil assembly of the end effector 400 relative to the lower jaw of the cartridge assembly of the end effector 400; articulation and / or rotation of the shaft assembly. And / or to drive the shaft and / or gear components for the purpose of firing the stapling and cutting cartridge in the cartridge assembly of the end effector 400.

  Shaft assembly 200 includes a force transmission assembly for interconnecting at least one drive member of a surgical instrument with at least one rotational receiving member of an end effector. The force transmission assembly has a first end connectable to the at least one rotatable drive member and a second end connectable to at least one rotation receiving member of the end effector. When the shaft assembly 200 fits into the surgical instrument 100, each of the rotatable drive members or connectors 118, 120, 122 of the surgical instrument 100 is associated with a corresponding rotatable connector sleeve 218, 220, 222 (see FIGS. 3 and 5). In this regard, an interface between the corresponding first drive member or connector 118 and the first connector sleeve 218, an interface between the corresponding second drive member or connector 120 and the second connector sleeve 220, And the interface between the corresponding third drive member or connector 122 and the third connector sleeve 222 is locked in rotation with a key so that the drive members or connectors 118, 120, Each rotation of 122 causes a corresponding rotation of the corresponding connector sleeve 218, 220, 222 of the shaft assembly 200.

  The mating of the drive member or connector 118, 120, 122 of the surgical instrument 100 with the connector sleeve 218, 220, 222 of the shaft assembly 200 is such that the rotational force is independent via each of the three respective connector interfaces. To be transmitted. The drive members or connectors 118, 120, 122 of the surgical instrument 100 are configured to be independently rotated by the drive mechanism. In this regard, the controller has a drive mechanism function selection module (not shown) that can be used to determine which drive member or connector 118, 120, 122 of the surgical instrument 100 is the input of the drive mechanism. Select whether to be driven by a drive component (not shown).

  Each drive member or connector 118, 120, 122 of surgical instrument 100 is keyed and / or substantially non-rotatable with a respective connector sleeve 218, 220, 222 of shaft assembly 200. When the shaft assembly 200 is coupled to the surgical instrument 100, the rotational force is transmitted from the drive mechanism of the surgical instrument 100 to the shaft assembly 200 and the end effector 400, as will be discussed in more detail below. Is selectively moved to.

  Selective rotation of the drive member or connector 118, 120, and / or 122 (s) of the surgical instrument 100 allows the surgical instrument 100 to selectively activate different functions of the end effector 400. To. As will be discussed in more detail below, selective and independent rotation of the first drive member or connector 118 of the surgical instrument 100 selectively opens and closes the end effector 400 and staples the end effector 400. Corresponds to driving the cutting component. Also, selective and independent rotation of the second drive member or connector 120 of the surgical instrument 100 selectively selects the end effector 400 in a direction across the longitudinal axis “X” (see FIG. 1). And it corresponds to independent joint movement. In addition, selective and independent rotation of the third drive member or connector 122 of the surgical instrument 100 causes the surgical operation of the end effector 400 about the longitudinal axis “X” (see FIG. 1). It accommodates selective and independent rotation of the instrument 100 relative to the instrument housing 102.

  According to the present disclosure, the drive mechanism may comprise a selector gear box assembly (not shown) and a function selection module (not shown), the function selection module being proximal to the selector gear box assembly. And functions to selectively move a gear element in the selector gearbox assembly to engage a second motor (not shown). This drive mechanism may be configured to selectively drive one of the drive members or connectors 118, 120, 122 of surgical instrument 100 at a predetermined time.

  As illustrated in FIGS. 1 and 2, the instrument housing 102 includes a pair of finger-actuated control buttons 124, 126, and / or one or more swing devices 130 (only one swing device). Is shown). Each of the control buttons 124, 126 and the swing device 130 is provided with a respective magnet (not shown), which is moved by the activation of the operator. In addition, a circuit board (not shown) housed in the instrument housing 102 includes respective Hall effect switches (not shown) for each of the control buttons 124, 126 and the swing device 130, and these holes. The effect switch is activated by movement of the control buttons 124, 126 and the magnet of the swing device 130. Specifically, the corresponding Hall effect switch (not shown) is located in the immediate vicinity of the control button 124, and this Hall effect switch is located in the control button 124 when the operator activates the control button 124. It starts when the magnet moves. Activation of a Hall effect switch (not shown) corresponding to the control button 124 causes the circuit board to provide an appropriate signal to close the end effector 400 and / or fire the stapling / cutting cartridge in the end effector 400. , Provided to the function selection module and input drive component of the drive mechanism.

  Also, a corresponding Hall effect switch (not shown) is located in the immediate vicinity of the control button 126, and this Hall effect switch is a magnet in the control button 126 when the operator activates the control button 126 ( It starts when moving (not shown). Activation of the Hall effect switch corresponding to the control button 126 causes the circuit board to provide appropriate signals for opening and closing the end effector 400 to the function selection module and input drive components of the drive mechanism.

  Further, a corresponding Hall effect switch (not shown) is located in the immediate vicinity of the swing device 130, and this Hall effect switch is located in the swing device 130 when the operator activates the swing device 130. It is activated when the magnet (not shown) moves. Activation of the Hall effect switch corresponding to the oscillating device 130 causes the circuit board to rotate the end effector 400 relative to the shaft assembly 200 or the end effector 400 and the shaft assembly 200 to the instrument housing 102 of the surgical instrument 100. Proper signals for rotation relative to the drive mechanism function selection module and input drive components are provided. Specifically, movement of the oscillating device 130 in a first direction causes the end effector 400 and / or shaft assembly 200 to rotate in a first direction relative to the instrument housing 102, while the oscillating device 130. Movement in the opposite (eg, second) direction causes end effector 400 and / or shaft assembly 200 to rotate relative to instrument housing 102 in the opposite (eg, second) direction.

  With reference now to FIGS. 1-29, the shaft assembly 200 is shown and described in detail. Shaft assembly 200 is configured to transmit the rotational force of first, second, and third rotatable drive members or connectors 118, 120, and 122 of surgical instrument 100 to end effector 400. As described above, the shaft assembly 200 is configured for selective connection to the surgical instrument 100.

  As seen in FIGS. 1, 2 and 4, the shaft assembly 200 has an elongate, substantially rigid outer tubular body 210 having a proximal end 210 a and a distal end 210 b; on the proximal end 210 a of the tubular body 210. A transmission housing 212 connected and configured for selective connection to the surgical instrument 100; and an articulating neck assembly 230 connected to the distal end 210b of the elongated body portion 210 are provided.

  The transmission housing 212 is configured to accommodate a pair of gear train systems that are configured to include first, second, and / or third rotatable drive members or connectors of the surgical instrument 100. The rotational speed / force of 118, 120, and / or 122 is to be changed (eg, increased or decreased) before such rotational speed / force is transmitted to the end effector 400.

  The transmission housing 212 of the shaft assembly 200 is configured and adapted to be connected to the connecting portion 108 a of the upper housing portion 108 of the surgical instrument 100. As seen in FIGS. 3-5, the transmission housing 212 of the shaft assembly 200 includes a shaft coupling assembly 214 supported at its proximal end.

  As seen in FIG. 5, the transmission housing 212 and shaft coupling assembly 214 are capable of rotating a first proximal or input drive shaft 224a, a second proximal or input drive shaft 226a, and a third drive shaft 228. To support.

  The shaft coupling assembly 214 is configured to rotatably support the first connector sleeve 218, the second connector sleeve 220, and the third connector sleeve 222. Each of the connector sleeves 218, 220, 222 is configured to mate with the first, second, and third drive members or connectors 118, 120, 122 of the surgical instrument 100, respectively, as described above. Each of the connector sleeves 218, 220, 222 is further configured to mate with a respective proximal end of the first input drive shaft 224a, the second input drive shaft 226a, and the third drive shaft 228. .

  The shaft drive coupling assembly 214 includes a first biasing member 218 a, a second biasing disposed at the distal end of each of the first connector sleeve 218, the second connector sleeve 220 and the third connector sleeve 222. A member 220a and a third urging member 222a are provided. Each of the biasing members 218a, 220a, and 222a is disposed about the first proximal drive shaft 224a, the second proximal drive shaft 226a, and the third drive shaft 228, respectively. The biasing members 218a, 220a and 222a act on the connector sleeves 218, 220 and 222, respectively, so that when the shaft assembly 200 is connected to the surgical instrument 100, the connector sleeves 218, 220 and 222 The 100 drive rotatable drive members or connectors 118, 120, 122 assist in maintaining engagement with the distal ends of each.

  Specifically, the first biasing member 218a, the second biasing member 220a, and the third biasing member 222a function to bias the respective connector sleeves 218, 220, and 222 in the proximal direction. To do. In this manner, while connecting the shaft assembly 200 to the surgical instrument 100, the first connector sleeve 218, the second connector sleeve 220, and / or the third connector sleeve 222 may be the drive member or connector of the surgical instrument 100. When misaligned with 118, 120, 122, the first biasing member 218a, the second biasing member 220a and / or the third biasing member 222a are compressed. Thus, when the drive mechanism of the surgical instrument 100 is engaged, the drive member or connector 118, 120, 122 of the surgical instrument 100 rotates and the first biasing member 218a, second biasing. The member 220a and / or the third biasing member 222a slide the first connector sleeve 218, the second connector sleeve 220 and / or the third connector sleeve 222 proximally, respectively, and return the surgical instrument 100. Are effectively coupled to the first input drive shaft 224a, the second input drive shaft 226a, and the third drive shaft 228, respectively.

  In use, during calibration of the surgical instrument 100, each of the drive connectors 118, 120, 122 of the surgical instrument 100 is rotated and the connector sleeves 218, 220, 222 are biased to achieve proper alignment. In some cases, connector sleeves 218, 220, and 222 are properly installed on respective drive connectors 118, 120, 122 of surgical instrument 100.

  Shaft assembly 200 includes a first gear train system 240 and a second gear train system 250 disposed within transmission housing 212 and tubular body 210 adjacent to coupling assembly 214. As described above, each gear train system 240, 250 provides the rotational speed / force of the first rotatable drive connector 118 and the second rotatable drive connector 120 of the surgical instrument 100 to such rotation. Are configured and adapted to change (eg, increase or decrease) prior to transmitting their speed / force to the end effector 400.

  As seen in FIGS. 5 and 6, the first gear train system 240 includes a first input drive shaft 224a and a first input drive shaft whose rotation is fixed to the first input drive shaft 224a with a key. A spur gear 242a is provided. The first gear train system 240 also includes a first transmission shaft 244 rotatably supported in the transmission housing 212, and a first input drive shaft spur gear fixed to the first transmission shaft 244 with a key. A first input transmission spur gear 244a that engages 242a, and a first output transmission spur gear 244b that is fixed to the first transmission shaft 244 by a key. The first gear train system 240 has a first output drive shaft 246a rotatably supported in the transmission housing 212 and the tubular body 110, and a first output drive shaft 246a fixed to the first output drive shaft 246a with a key. A first output drive shaft spur gear 246b that engages the output transmission spur gear 244b.

  According to the present disclosure, the first input drive shaft spur gear 242a comprises 10 teeth; the first input transmission spur gear 244a comprises 18 teeth; and the first output transmission spur gear 244b comprises 13 teeth. And the first output drive shaft spur gear 246b has 15 teeth. When configured in this way, the input rotation of the first input drive shaft 224a is converted to the output rotation of the first output drive shaft 246a in a ratio of 1: 2.08.

  As described above, the proximal end of the first input drive shaft 224a is configured to support the first connector sleeve 218.

  In operation, the first input drive shaft due to the rotation of the first connector sleeve 218 and the first input drive shaft 224a as a result of the rotation of the corresponding first drive connector 118 of the surgical instrument 100. As the spur gear 242a rotates, the first input drive shaft spur gear 242a engages the first input transmission spur gear 244a and rotates the first input transmission spur gear 244a. As the first input transmission spur gear 244a rotates, the first transmission shaft 244 rotates, thus rotating the first output transmission spur gear 244b whose rotation is fixed to the first transmission shaft 244 with a key. When the first output transmission spur gear 244b rotates, the first output drive shaft spur gear 246b also rotates because the first output drive shaft spur gear 246b is engaged therewith. When the first output drive shaft spur gear 246b rotates, the first output drive shaft spur gear 246b is fixed to the first output drive shaft 246a with a key so that the first output drive shaft 246a rotates. To do.

  As discussed in more detail below, the shaft assembly 200 comprising the first gear system 240 provides actuation force from the surgical instrument 100 to the end effector 400 for the purpose of actuating, activating and / or firing the end effector 400. And function to communicate.

  As seen in FIGS. 5 and 7, the second gear train system 250 includes a second input drive shaft 226a and a second input drive shaft whose rotation is fixed to the second input drive shaft 226a with a key. A spur gear 252a is provided. The second gear train system 250 also includes a first transmission shaft 254 rotatably supported in the transmission housing 212, and a second input drive shaft spur gear fixed to the first transmission shaft 254 with a key. A first input transmission spur gear 254a engaged with 252a and a first output transmission spur gear 254b fixed to the first transmission shaft 254 with a key are provided.

  The second gear train system 250 has a second transmission shaft 256 rotatably supported in the transmission housing 212, and the second transmission shaft 256 is fixed to the second transmission shaft 256 with a key to be rotated to a first output transmission spur gear 254 b ( A second input transmission spur gear 256a that engages the first transmission shaft 254 with a key), and a second output that has a key fixed to the second transmission shaft 256. A transmission spur gear 256b is further provided.

  The second gear train system 250 has a second output drive shaft 258a rotatably supported in the transmission housing 212 and the tubular body 210, and a second output drive shaft 258a fixed to the second output drive shaft 258a with a key. A second output drive shaft spur gear 258b that engages the output transmission spur gear 256b.

  According to the present disclosure, the second input drive shaft spur gear 252a has 10 teeth; the first input transmission spur gear 254a has 20 teeth; the first output transmission spur gear 254b has 10 teeth. The second input transmission spur gear 256a has 20 teeth; the second output transmission spur gear 256b has 10 teeth; and the second output drive shaft spur gear 258b has 15 teeth With teeth. When configured in this way, the input rotation of the second input drive shaft 226a is converted to the output rotation of the second output drive shaft 258a in a 1: 6 ratio.

  As described above, the proximal end of the second input drive shaft 226 a is configured to support the second connector sleeve 220.

  In operation, due to the rotation of the second connector sleeve 220 and the second input drive shaft 226a as a result of the rotation of the corresponding second drive connector 120 of the surgical instrument 100, the second input drive shaft. As the spur gear 252a rotates, the second input drive shaft spur gear 252a engages the first input transmission spur gear 254a and rotates the first input transmission spur gear 254a. When the first input transmission spur gear 254a rotates, the first transmission shaft 254 rotates, and thus the first output transmission spur gear 254b whose rotation is fixed to the first transmission shaft 254 with a key is rotated. When the first output transmission spur gear 254b is rotated, the second input transmission spur gear 256a is also rotated because the second input transmission spur gear 256a is engaged therewith. When the second input transmission spur gear 256a rotates, the second transmission shaft 256 rotates, and accordingly, the second output transmission spur gear 256b whose rotation is fixed to the second transmission shaft 256 with a key is rotated. When the second output transmission spur gear 256b rotates, the second output drive shaft spur gear 258b is engaged with this, so the second output drive shaft spur gear 258b rotates. When the second output drive shaft spur gear 258b rotates, the second output drive shaft spur gear 258b is fixed to the second output drive shaft 258a with a key so that the second output drive shaft 258a rotates. To do.

  As will be discussed in more detail below, the shaft assembly 200 with the second gear train system 250 is configured to apply an actuation force to the shaft assembly 200 and / or the end effector 400 for the purpose of rotating the surgical instrument 100 relative to the surgical instrument 100. It functions to transmit from the surgical instrument 100 to the end effector 400.

  As described above and as seen in FIGS. 5 and 8, the transmission housing 212 and shaft coupling assembly 214 rotatably support a third drive shaft 228. The third drive shaft 228 extends to the articulation assembly 270 and extends to the proximal end 228a configured to support the third connector sleeve 222 and the articulation assembly 270 as discussed in more detail below. A distal end 228b is provided that is operatively connected.

  As can be seen in FIG. 4, the elongate outer tubular body 210 of the shaft assembly 200 comprises a first half section 211a and a second half section 211b, which half sections 211a and 211b fit together. When combined, it defines at least three channels extending longitudinally through the outer tubular body 210. These channels are provided when the first output drive shaft 246a, the second output drive shaft 258a, and the third drive shaft 228 extend from the transmission housing 212 to the articulating neck assembly 230. 246a, second output drive shaft 258a, and third drive shaft 228 are configured and dimensioned to receive and support rotatably. Each of the first output drive shaft 246a, the second output drive shaft 258a, and the third drive shaft 228 is elongated and substantially rigid so that the neck assembly 230 articulates rotational force from the transmission housing 212. Communicate to.

  With reference now to FIGS. 4 and 9-16, an articulating neck assembly 230 is shown and described. The articulating neck assembly 230 includes a proximal neck housing 232, a plurality of links 234 connected to the proximal neck housing 232 and extending in series from the proximal neck housing 232; and the most distal link of the plurality of links 234 A distal neck housing 236 connected to and extending from the most distal link.

  Each link 234 includes cooperating knuckles and clevises formed on its proximal surface 234a and distal surface 234b, respectively. Proximal neck housing 232 includes a knuckle and / or clevis that operatively engages the knuckle and / or clevis of the proximal link. The distal neck housing 236 includes a knuckle and / or clevis that operatively engages the knuckle and / or clevis of the most distal link. Although adjacent the neck housings 232, 236 and the link 234, the knuckles and clevis operably engage one another to define the direction and angle of articulation of the neck assembly 230.

  Neck assembly 230 allows end effector 400 to move between a substantially linear configuration, a substantially angled configuration, an off-axis configuration, or an articulated configuration. Configured to do. According to the present disclosure, it is envisioned that the neck assembly 230 can articulate in a single plane and can articulate about 90 °, and even greater than 90 °.

Each link 234 has a first lumen 234c (see FIG. 12) for passage of the distal drive cable 271; a first pair of oppositions for passage of the pair of articulation cables 262, 264 Defining a lumen 234d ₁ , 234d ₂ ; and a second lumen 234e opposite the first lumen 234c. As seen in FIG. 12, the first lumen 234c and the second lumen 234e are diametrically opposed to each other and are offset by 90 ° relative to the lumens 234d ₁ , 234d ₂ . The first drive cable or shift cable 266 includes a proximal end that is keyed and secured to the distal end of the first output drive shaft 246a (FIG. 4) via a coupling member 247a. The second drive cable 268 is supported in the neck assembly 230 and includes a proximal end that is keyed and secured to the distal end of the second output drive shaft 258a (FIG. 4) via the coupling member 247b. . Each of the first drive cable 266 and the second drive cable 268, and each of the distal drive cables 271 are flexible and torsionally stiff (capable of transmitting rotational force or torque). (For example, stainless steel).

  As seen in FIG. 13, the proximal neck housing 232 of the neck assembly 230 supports an articulation assembly 270 configured and adapted to impart articulation to the neck assembly 230 and / or the end effector 400. The articulation assembly 270 includes a pair of opposing gear racks 272, 274 that engage the pinion gear on both sides of the pinion gear 276. The racks 272, 274 are axially slidably supported within the proximal neck housing 232, and the pinion gear 276 is rotatably supported within the proximal neck housing 232.

  As seen in FIGS. 12 and 13, the rack 274 is attached to a threaded shaft 272a extending proximally from the rack, the threaded shaft 272a being distal to the internally threaded nut 278. Engage with the end by screwing. The threaded nut 278 is rotatably supported in a pocket 232a formed in the proximal neck housing 232 and is fixed axially. The proximal end of the threaded nut 278 is keyed to rotation at the distal end of the third drive shaft 228. Although the threaded shaft 272a is illustrated as extending from the rack 274, it is understood that the threaded shaft may extend from the rack 272 without departing from the principles of the present disclosure and Within the scope of the disclosure.

Articulation cables 262, 264 have proximal ends that are secured to and extend from the distal ends of racks 272, 274, respectively. Each articulation cable 262, 264 includes a distal end that extends through opposing lumens 234 d ₁ , 234 d ₂ of link 234, respectively, and is fixed or anchored to distal neck housing 236. Is done.

  In operation, in order to articulate the neck assembly 230 in the first direction, the third drive shaft 228 as described above is rotated in the first direction to rotate the threaded nut 278 and threading. The displaced shaft 272a is axially displaced distally, and the rack 274 is axially displaced distally. When the rack 274 is displaced axially in the distal direction, the rack 274 rotates the pinion gear 276 and thus acts on the rack 272 to axially displace the rack 272 in the proximal direction. As the rack 272 is axially displaced in the proximal direction, the rack 272 pulls the articulation cable 262 in the proximal direction, thereby articulating the neck assembly 230. The neck assembly 230 is allowed to articulate because the axial displacement of the rack 274 in the distal direction results in the axial displacement of the articulation cable 264 in the distal direction.

  14-29, the distal neck housing 236 functions as a gear box and includes a first or proximal planetary gear system 280 and a second or distal cylindrical gear system 290. To support. The first planetary gear system 280 and the distal cylindrical gear system 290 function in cooperation with each other to translate each of the first drive cable or shift cable 266 or the second drive cable 268. The rotation is transmitted to the end effector 400 to both fire the end effector 400 and rotate the end effector 400. In other words, the first or proximal planetary gear system 280 and the second or distal cylindrical gear system 290 have a single rotatable drive member (ie, the first drive cable or shift cable 266, the second The second drive cable 268) is configured to convert the rotational input of the second drive cable 268) into at least two output forces on the end effector 400, the first output force firing the end effector 400 and the second output force. Rotates the end effector 400.

  The distal neck housing 236 includes an outer tubular housing 237 that defines a set of radial gear teeth 237a on its inner surface near its proximal end.

  In one embodiment, the distal end of the second drive cable 268 rotatably engages a gear pair 269 supported in the distal neck housing 236, and the gear pair 269 is attached to the distal drive cable 271. Transmits rotation. The distal drive cable 271 selectively engages a first spur gear 238 a supported on the distal neck housing 236. The first spur gear 238 a is engaged with a second spur gear 238 b that is non-rotatably supported on the central distal drive shaft 239, and the distal drive shaft 239 is distant from the articulating neck assembly 230. A pivot neck housing 236 is rotatably supported.

  As seen in FIGS. 16-20 and 22-26, the first planetary gear system 280 of the distal neck housing 236 includes a first sun gear that is non-rotatably supported on the distal drive shaft 239. 282, a first ring gear 284 surrounding the first sun gear 282, and between the first spur gear 282 and the first ring gear 284, the first spur gear 282 and the first ring And a plurality of first planetary gears 286 interengaging with the gears 284. The plurality of first planetary gears 286 are rotatably supported by the respective stems 288 a of the carrier 288. Carrier 288 is rotatably supported within distal neck housing 236. The carrier 288 non-rotatably supports the crown gear 289 on the stem 288a such that rotation of the crown gear 289 results in rotation of the carrier 288 and the first planetary gear 286. The crown gear 289 defines a plurality of teeth 289a radially about its outer rim, the teeth 289a extending through the distal surface of the crown gear 289 or only from the distal surface of the crown gear 289.

  As seen in FIGS. 16-18 and 21-26, the distal cylindrical gear system 290 of the distal neck housing 236 is non-rotatably supported by the carrier 288 and extends from the carrier 288. A sun gear 292 and at least one second planetary gear 296 engaged with the second sun gear 292. In one embodiment, the annular flange is distally beyond the distal cylindrical gear system 290 such that rotation of the first ring gear 284 results in rotation of the hub 311 of the end effector coupling assembly 310. Extending from the first ring gear 284 to extend and non-rotatably engage the rotating hub 311 of the end effector coupling assembly 310 (eg, welded, bolted, press fit together). is assumed.

  Referring back to FIGS. 16-20 and 22-26, the distal neck housing 236 supports the locking collar gear 240 therein. Lock collar gear 240 is supported on distal neck housing 236 and includes a plurality of radially outwardly extending teeth 240a (in the form of spur gears) engaged with teeth 237a of tubular housing 237; A plurality of distally directed teeth 240b (in the form of crown gears) extending radially inwardly of the innermost surface. Lock collar gear 240 rotates relative to crown gear 289 between a proximal position engaged with crown gear 289 of first planetary gear system 280 and a distal position disengaged from crown gear 289. It is possible to slide.

  In operation, when the locking collar gear 240 is in a proximal engaged position with the crown gear 289, as seen in FIGS. 17, 18 and 22-24, inwardly toward the distal direction. The protruding tooth 240b engages the crown tooth 289a of the crown gear 289, so that the radially outwardly extending tooth 240a of the lock collar gear 240 is engaged with the tooth 237a of the tubular housing 237. The crown gear 289 and the carrier 288 are prevented from rotating.

  Also, in operation, when the locking collar gear 240 is in a distal disengaged position with the crown gear 289, its projecting inward toward the distal direction, as seen in FIGS. The tooth 240b is disengaged from the crown tooth 289a of the crown gear 289, so that the crown gear 289 and the carrier 288 rotate due to the rotation of the spur gear 282. With the lock collar gear 240 disengaged from the crown gear 289, the crown gear 289, and thus the carrier 288, is allowed to rotate.

  In overall operation, when the second drive cable 268 is rotated, rotation of the second output drive shaft 258a (as described above) causes the rotation to occur as shown in FIGS. It is transmitted to the distal drive cable 271 via the pair 269. When the distal drive cable 271 is rotated, the rotation is transmitted directly to the central distal drive shaft 239 because the central distal drive shaft 239 is non-rotatably secured to the distal drive cable 271.

  Depending on the positioning of the locking collar gear 240 relative to the crown gear 289 of the first planetary gear system 280, rotation of the central distal drive shaft 239 may cause the end effector 400 to close / fire and open / retract, or the end effector 400 to rotate. Bring one of the rotations. For example, in one embodiment, the lock collar gear 240 is located in the distal position (as described above and illustrated in FIGS. 25 and 26), disengaged from the crown gear 289, and the first When locked into engagement with the other ring gear 284, rotation of the central distal drive shaft 239 results in closing / firing and opening / retraction of the end effector 400. Further, in one embodiment, the locking collar gear 240 is located in the proximal position (as described above and as illustrated in FIGS. 17, 18 and 22-24), and the crown gear 289 and When engaged and disengaged from the first ring gear 284, rotation of the central distal drive shaft 239 results in rotation of the end effector 400.

  Continuing with the discussion of operation, in order to rotate the end effector 400, as seen in FIGS. 17, 18 and 22-24, the lock collar gear 240 is moved to a proximal position to provide a crown gear. 289 is engaged and the crown gear 289 is non-rotatably connected to the carrier 288 via the stem 288a so that the non-rotation of the carrier 288 results in the non-rotation of the crown gear 289. Thus, with the crown gear 289 unable to rotate, rotation of the central distal drive shaft 239 is transmitted to the first sun gear 282, resulting in rotation of the first sun gear 282, and then a plurality of first The planetary gears 286 provide rotation about their respective central axes defined by the stems 288a of the carrier 288. As the first planetary gears 286 are rotated about their respective central axes defined by the stem 288a of the carrier 288, the first planetary gears 286 mesh with the teeth 284a of the first ring gear 284; The rotation is transmitted to the first ring gear 284.

  With the locking collar gear 240 locked to the crown gear 289, the first ring gear 284 is rotatable relative to the tubular housing 237. When so positioned, rotation of the central distal drive shaft 239 rotates the first sun gear 282, which causes the first planetary gear 286 (as defined by the stem 288a of the carrier 288). ) Rotate around their respective central axes. As the first planetary gear 286 rotates, the first planetary gear 286 drives a first ring gear 284 that is fixedly or non-rotatably fixed to the distal housing or rotating hub 311. Accordingly, when the end effector 400 is connected to the shaft assembly 200, particularly when the alignment stems 424 a and 424 b of the end effector 400 are connected to the rotating hub 311, the rotation of the rotating hub 311 is caused by the rotation of the end effector 400. Bring.

  Continuing with the discussion of operation, in order to close / fire and open / retract end effector 400, as seen in FIGS. 25 and 26, lock collar gear 240 is moved to a distal position to provide crown gear. 289 is disengaged and locked in engagement with the first ring gear 284. Thus, rotation of the central distal drive shaft 239 results in rotation of the carrier 288, with the crown gear 289 being able to rotate.

  As the carrier 288 is rotated, the carrier 288 transmits the rotation to the second sun gear 292 of the distal cylindrical gear system 290. When the second sun gear 292 is rotated, the second sun gear 292 transmits the rotation to at least one second gear 296. When the second gear 296 is rotated, the second gear 296 transmits the rotation to the firing connector 297, which in turn drives the drive shaft 426 (FIGS. 27, 29, and 30 of the end effector 400). ), And is configured to fire and close the end effector 400.

  In accordance with one embodiment of the present disclosure, it is envisioned that the lock collar gear 240 is biased to the distal position and the lock collar gear 240 is engaged with the crown gear 289. Such an arrangement serves as a fail safe and the shaft assembly 200 returns to the fire (or retract) mode. It is envisioned that the distal neck housing 236 may include a biasing member 244 positioned to work on the locking collar gear 240 and to urge the locking collar gear 240 to a proximal position.

  In accordance with one embodiment of the present disclosure, as seen in FIGS. 9, 10, 12, 14-16, 18, and 24-28, the first drive cable or shift of the shaft assembly 200 The cable 266 has a first end attached to the lock collar gear 240 and a second end extending through the shaft assembly 200 to be accessible from a location outside the surgical field or surgical cavity. It is assumed to include. In particular, the distal end of the shift cable 266 can be secured to the lock collar gear 240 and the threaded proximal end 266a of the shift cable 266 rotates into the proximal neck housing 232 in the form of a threaded nut. It can be threadably connected to an elongate coupling member 274a that is supported. In this manner, when the threaded nut 247a is rotated in the first direction (via the first output drive shaft 246a), the threaded nut 247a acts on the threaded proximal end 266a of the shift cable 266. Thus, the shift cable is moved in the first axial direction (either the distal direction or the proximal direction), and the lock collar gear 240 is simultaneously moved in the axial direction. Further, when the threaded nut 247a is rotated in the second direction (the direction opposite to the first direction) (by the first output drive shaft 246a), the threaded nut 247a is threaded on the shift cable 266. The shift cable is moved in the second axial direction (axial direction opposite to the first axial direction) by acting on the proximal end 266a, and the lock collar gear 240 is simultaneously moved in the axial direction.

  In further embodiments, it is envisioned that shift cable 266 may also be biased to a distal position. In one embodiment, the spring rate / constant of the biasing member associated with the shift cable 266 is greater than the spring rate / constant of the biasing member 244 associated with the lock collar gear 240.

  The shift cable 266 so configured is fully pulled (proximal) even though the teeth 240b of the lock collar gear 240 are aligned with the teeth 289a of the crown gear 289 and thus prevented from engaging. So that the biasing member associated with the shift cable 266 is relative to the crown gear 289 until the distal drive shaft 239 of the distal neck housing 236 is rotated. , Where the torque rotates the first sun gear 282 and the crown gear 289, thereby allowing the teeth 240b of the lock collar gear 240 to engage the teeth 289a of the crown gear 289.

  The reverse occurs when the shift cable 266 is released from the proximal position. With the lock collar gear 240 spring loaded toward the crown gear 289, the biasing member 242 even if the teeth of the lock collar gear 240 are aligned with the teeth of the crown 289 and thus prevented from engaging. Holds the locking collar gear 240 against the crown gear 289 until the distal drive shaft 239 of the distal neck housing 236 is rotated, where torque rotates the first sun gear 282 and the crown gear 289. Thereby allowing the teeth of the lock collar gear 240 to mesh with the teeth of the crown gear 289.

  By providing a first gear system 280 and a second gear system 290 in the distal neck housing 236 (at a location between the articulating neck assembly 230 and the end effector 400), a single rotatable Only drive is required to be driven / rotated through the articulating neck assembly 230. Furthermore, the use of the first planetary gear system and the second planetary gear system allows for greater torque reduction in a shorter axial direction as compared to a gear system made with a series of compound gears.

  As seen in FIGS. 14, 15 and 27-29, the shaft assembly 200 further includes an end effector coupling assembly 310 supported at the distal end of the distal neck housing 236 of the articulating neck assembly 230. . The end effector coupling assembly 310 includes a collar 312 that is rotatably supported by the distal neck housing 236, extends distally from the distal neck housing 236, and a first radial position. Be energized by. The collar 312 is rotatable from a first radial position to a second radial position (in this second radial position, the end effector 400 is engageable with the end effector coupling assembly 310). And the biasing returns to the first radial position to lock the end effector 400 to the shaft assembly 200. In one embodiment, the biasing can be accomplished by a compression spring disposed in an outer annular groove formed in the rotating hub 311 that works against a tab or other feature provided on the collar 312. .

  The collar 312 includes at least one nub 312a extending radially inward from its inner surface, the nub being received in a corresponding complementary structure 422a formed on the outer surface of the end effector 400; It is envisioned that the end effector 400 may be connected to the shaft assembly 200 with a bayonet-type connection. Other forms of connection (eg, detents, screw connections, etc.) are envisioned.

  Referring now to FIGS. 27-30, an exemplary end effector 400 for use with the surgical instrument 100 and shaft assembly 200 is illustrated. For a detailed discussion of the configuration and operation of the end effector 400, reference may be made to US patent application Ser. No. 13 / 280,898, filed Oct. 25, 2011, the entire contents of which are incorporated herein by reference. Incorporated as. As seen in FIGS. 27-30, the end effector assembly 400 includes a drive shaft 426 that is rotatably supported by the coupling member 422 and protrudes proximally from the coupling member 422 to provide an end effector. When 400 is coupled to shaft assembly 200, it is configured for mating engagement with firing connector 297 of distal neck housing 236. The drive shaft 426 functions to transmit the rotational drive force from the firing connector 297 of the distal neck housing 236 of the shaft assembly 200 to the lower jaw drive screw 464 of the end effector 400 jaw assembly.

  As seen in FIGS. 27-30, coupling member 422 is proximally coupled from coupling member 422 for receiving into respective alignment bores 310a, 310b formed in the distal surface of end effector coupling assembly 310. Includes a pair of spaced alignment stems 424a, 424b.

  In one embodiment, shaft assembly 200 may include at least one clutch mechanism (not shown) to reduce the event that the end user excessively torques the gears of distal neck housing 236. is assumed. At least one clutch mechanism includes a first clutch mechanism (not shown) that is placed between the lock collar gear 540 and the crown gear 589 when the lock collar gear 540 is in the proximal position, and the lock collar gear 540 includes It is envisioned to include a second clutch mechanism (not shown) that is placed between the lock collar gear 540 and the first ring gear 584 when in the distal position. In this manner, when the user manually grabs the end effector and rotates the end effector relative to the adapter assembly, the end effector lead screw is not displaced.

  In one embodiment, it is envisioned that each clutch mechanism may include a friction enhancing material such as (such as (steel-steel or rubber or silicone overmolded)). In this embodiment, the clutch force between the lock collar gear 540 and the crown gear 589 can be controlled by the amount of tension exerted on the lock collar gear 540 by the shift cable 266. In particular, if the tensile force exerted on the lock collar gear 540 is relatively high, the clutch force is relatively higher (ie, a relatively greater torque to rotate the lock collar gear 540 relative to the crown gear 589). Is required). When the tensile force exerted on the lock collar gear 540 is relatively lower, the clutch force is relatively lower (ie, a relatively reduced torque is required to rotate the lock collar gear 540 relative to the crown gear 589). It is necessary).

  Further, the clutch force between the lock collar gear 540 and the first ring gear 584 can be controlled by the amount of any distally directed force exerted on the lock collar gear 540. In particular, if the distally directed force exerted on the lock collar gear 540 is relatively higher, the clutch force is relatively higher (ie, rotating the lock collar gear 540 relative to the first ring gear 584). Relatively large torque is required to achieve this). If the distally directed force exerted on the lock collar gear 540 is relatively lower, the clutch force is relatively lower (ie, to rotate the lock collar gear 540 relative to the first ring gear 584). In other words, a relatively reduced torque is required).

  In a further embodiment, as seen in FIGS. 31-36, the shaft assembly 200 includes a series of ramp gear teeth 540b formed on / in the inner surface of the lock collar gear 540, and a crown gear 589. It is further envisaged that a clutch mechanism may be provided that includes a series of ramp gear teeth 589a formed at / in the outer surface of the wheel. In this embodiment, the clutch force may be controlled by the number of gear teeth 540b, 589a, the dimensions of the gear teeth 540b, 589a, and the like.

  In particular, the proximal surface of each ramp gear tooth 540b of the lock collar gear 540 is chamfered at an angle, and the distal surface of each ramp gear tooth 589a of the crown gear 589 is chamfered at an angle. It is envisioned that the angle of the proximal surface of each ramp gear tooth 540b of lock collar gear 540 is substantially complementary to the angle of the distal surface of each ramp gear tooth 589a of crown gear 589. .

  More particularly, the proximal surface of each ramp gear tooth 540b of the lock collar gear 540 has a pair of surfaces extending in opposite directions from each other along a surface extending radially from the central axis of the lock collar gear 540. Including, the pair of surfaces diverge distally from each other. Further, the distal surface of each ramp gear tooth 589a of crown gear 589 includes a pair of surfaces extending in opposite directions from each other along a surface extending radially from the central axis of crown gear 589. The surfaces of each of them diverge in a proximal direction from each other.

  In use, as described above, the gears of the distal neck housing 236 receive torque or rotational force from the surgical instrument 100. This torque is highly controlled and can be accurately limited, but (as described above) when the lock collar gear 540 is in the proximal rotational position, the user is forced (ie, manually) to end The effector 400 can be rotated or torque can be exerted on the end effector 400 so that the motor or other component of the surgical instrument 100 and / or the neck assembly 200 can be damaged. The angle of the ramp gear teeth 540b, 589a of the clutch mechanism serves to limit the amount of torque that the end user can overload. The amount of torque required to slip the clutch mechanism includes the number of gear teeth 540b, 589a, and the angle of inclination of the pair of proximal surfaces of each ramp gear tooth 540b of the lock collar gear 540, and Depending on the angle of inclination of a pair of distal surfaces of each ramp gear tooth 589a of the crown gear 589, and the like.

  In operation, when the lock collar gear 540 is in the distal or firing position, torque from the surgical instrument 100 is transmitted through the gear of the distal neck housing 236 to drive the drive shaft 426 of the end effector 400 (FIG. 27, 29 and 30), thereby firing and closing the end effector 400. In this situation, the end user cannot cause excessive external torque by pressing the knife bar of the end effector 400.

  However, by adding a clutch mechanism to the drive shaft 426 of the end effector 400 (not shown), the failure mode of the surgical instrument 100 from the excessive torque of the surgical instrument 100 motor can be reduced or eliminated. obtain.

  In a further embodiment, as seen in FIGS. 37-43, the locking collar gear 540 of the shaft assembly 200 can be used to selectively engage the first ring gear 584 when in the advanced position. And in the retracted position, it is envisioned that it has been replaced by a lock pin 560 that is translationally supported within the distal neck housing 236 to selectively engage the crown gear 589. .

  As seen in FIG. 38, the lock pin 560 includes a cylindrical body 562 that defines a distal end 562a and a proximal end 562b. The distal end 562a of the cylindrical body 562 defines a flat or recess 562c formed in the side surface thereof. The lock pin 560 includes teeth 564 supported or integrally formed at the distal end 562a of the cylindrical body 562. The teeth 564 include a distal portion 564a that extends distally from the distal most end of the cylindrical body 562. The teeth 564 include a proximal portion 564b that extends proximally from the most distal end of the cylindrical body 562 and protrudes into the flat 562c of the cylindrical body 562. Proximal portion 564b of tooth 564 defines a tapered shape or the like.

  As seen in FIGS. 39-43, the lock pin 560 is such that the crown gear 589 is positioned within the flat 562c of the lock pin 560 and adjacent to the tapered portion 564b of the tooth 564. Is supported within the distal neck housing 236.

  With continued reference to FIGS. 39-43, the first ring gear 584 comprises an annular array of notches 584b formed in its proximal surface. Each notch 584b is configured and dimensioned to selectively receive the distal portion 564a of the tooth 564 of the lock pin 560.

  In operation, the lock pin 560 includes a retracted position in which the proximal portion 564b of the tooth 564 of the lock pin 560 is engaged in the tooth 589a of the crown gear 589 and the distal portion 564a of the tooth 564 of the lock pin 560. The first ring gear 584 can be translated between the advanced position disposed in the notch 584a of the first ring gear 584.

  Lock pin 560 is translated between a retracted position and an advanced position by a push / pull cable or shift cable 266 secured to the proximal end of lock pin 560. In particular, it is envisioned that the proximal end of lock pin 560 may be crimped to the distal end of shift cable 266. In this manner, when the shift cable 266 is translated axially between the retracted position and the advanced position, the shift cable 266 moves the lock pin 560 forward and backward, respectively. Translate between the given position.

  In operation, when the lock pin 560 is in the retracted or proximal position and is engaged with the crown gear 589, the proximal portion 564b of the tooth 564 of the lock pin 560 is aligned with the tooth 589a of the crown gear 589. The crown gear 589 and the carrier 288 are prevented from rotating due to the engagement and consequently the body 562 of the lock pin 560 engaged with the teeth 237a of the tubular housing 237 (see FIG. 37). about).

  Also, in operation, when the lock pin 560 is in the advanced or distal position and disengaged from the crown gear 589, the proximal portion 564b of the tooth 564 of the lock pin 560 causes the crown gear 589 to As a result, the crown gear 589 and the carrier 288 are rotated by the rotation of the spur gear 282. Lock pin 560 is disengaged from crown gear 589 and crown gear 589, and thus carrier 288, is allowed to rotate.

  Further, when the lock pin 560 is in the advanced or distal position, the distal portion 564a of the lock pin 560 is disengaged from the crown gear 589 and is in engagement with the first ring gear 584. Locked. Accordingly, rotation of the central distal drive shaft 239 results in rotation of the carrier 288 with the crown gear 589 enabled to rotate. As the carrier 288 is rotated, the carrier 288 transmits the rotation to the second sun gear 292 of the distal cylindrical gear system 290. When the second sun gear 292 is rotated, the second sun gear 292 transmits the rotation to at least one second gear 296. When the second gear 296 is rotated, the second gear 296 transmits the rotation to the firing connector 297, which in turn drives the drive shaft 426 (FIGS. 27, 29, and 30 of the end effector 400). ), And is configured to fire and close the end effector 400.

  Depending on the positioning of the lock pin 560, rotation of the central distal drive shaft 239 relative to the crown gear 589 of the first planetary gear system 280 may cause the end effector 400 to close / fire and open / retract, or the end effector 400 to rotate. Bring one of them. For example, in one embodiment, rotation of the central distal drive shaft 239 when the lock pin 560 is located in the advanced or distal position and disengaged from the crown gear 589 (as described above). Provides closing / firing and opening / retraction of the end effector 400. Further, in one embodiment, when the lock pin 560 is in the retracted or proximal position and is engaged with the crown gear 589 (as described above), the rotation of the central distal drive shaft 239 is , Causing the end effector 400 to rotate.

  Continuing the discussion of operation, to rotate the end effector 400, the lock pin 560 is moved to the retracted or proximal position to engage the crown gear 589, and the crown gear 589 engages the stem 288a. The non-rotation of the carrier 288 causes the crown gear 589 to not rotate. Thus, with the crown gear 589 unable to rotate, the rotation of the central distal drive shaft 239 is transmitted to the first sun gear 282, resulting in rotation of the first sun gear 282, and then a plurality of first The planetary gears 286 provide rotation about their respective central axes defined by the stems 288a of the carrier 288. As the first planetary gears 286 are rotated about their respective central axes defined by the stem 288a of the carrier 288, the first planetary gears 286 mesh with the teeth 284a of the first ring gear 284; The rotation is transmitted to the first ring gear 284.

  With the lock collar gear 540 locked to the crown gear 589, the first ring gear 284 can rotate relative to the tubular housing 237. When so positioned, rotation of the central distal drive shaft 239 rotates the first sun gear 282, which causes the first planetary gear 286 (as defined by the stem 288a of the carrier 288). ) Rotate around their respective central axes. As the first planetary gear 286 rotates, the first planetary gear 286 drives a first ring gear 284 that is fixedly or non-rotatably fixed to the distal housing or rotating hub 311. Accordingly, when the end effector 400 is connected to the shaft assembly 200, particularly when the alignment stems 424 a and 424 b of the end effector 400 are connected to the rotating hub 311, the rotation of the rotating hub 311 is caused by the rotation of the end effector 400. Bring.

  Continuing the discussion of operation, in order to close / fire and release / retract end effector 400, lock pin 560 is moved to a distal position and disengaged from crown gear 589 to provide a first ring gear. Locked into engagement with H.284. Thus, rotation of the central distal drive shaft 239 results in rotation of the carrier 288 with the crown gear 589 capable of rotation.

  As the carrier 288 is rotated, the carrier 288 transmits the rotation to the second sun gear 292 of the distal cylindrical gear system 290. When the second sun gear 292 is rotated, the second sun gear 292 transmits the rotation to at least one second gear 296. When the second gear 296 is rotated, the second gear 296 transmits the rotation to the firing connector 297, which in turn drives the drive shaft 426 (FIGS. 27, 29, and 30 of the end effector 400). ), And is configured to fire and close the end effector 400.

  It is envisioned that if lock pin 560 is in an “intermediate” position between the distal and proximal positions, a more restrictive function of the closure / fire and rotation functions may be implemented.

  It will be understood that various modifications may be made to the embodiments disclosed herein. For example, surgical instrument 100 and / or cartridge assembly 410 need not necessarily apply staples, but rather may apply two-part fasteners as is known in the art. Further, the length of the linear row of staples or fasteners can be modified to suit the requirements of a particular surgical procedure. Accordingly, the length of the linear row of staples and / or fasteners within the staple cartridge assembly may vary accordingly. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

10 Electromechanical Surgical System 100 Surgical Instrument 102 Instrument Housing 108a Connection 200 Shaft Assembly 212 Transmission Housing 230 Articulating Neck Assembly 236 Distal Neck Housing 400 End Effector

Claims (20)

An electromechanical surgical system, the electromechanical surgical system comprising:
A hand-held surgical instrument including an instrument housing defining a connection portion for selective connection with a shaft assembly, the surgical instrument having at least one rotatable drive member; ,
An end effector configured to perform at least one function;
The shaft assembly disposed to selectively interconnect the end effector and the surgical instrument, the shaft assembly comprising:
A transmission housing configured and adapted for selective connection to the connection portion of the surgical instrument, the transmission housing being one of the at least one rotatable drive member of the surgical instrument. A transmission housing configured and adapted to be in operative communication with each other;
An outer tubular body having a proximal end supported by the transmission housing and a distal end configured and adapted for operative connection with the end effector;
A distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotary receiving member supported within the end effector, the distal neck housing being one of the surgical instrument. A force transmission assembly including a first end connectable to one rotatable drive member and a second end connectable to the rotation receiving member of the end effector. Transmitting possible drive member rotation to the rotation receiving member of the end effector, the distal neck housing comprising:
Including at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces on the end effector;
A distal neck housing;
An articulating neck assembly interconnecting the tubular body and the distal neck housing, wherein the articulating neck assembly allows articulation off-axis of the distal neck housing An electromechanical surgical system, wherein the rotatable drive member includes an articulating neck assembly extending through the articulating neck assembly.   The electromechanical surgical system according to claim 1, wherein a first output force of the at least one gear system of the distal neck housing results in firing of the end effector.   The electromechanical surgical system according to claim 2, wherein the first output force of the at least one gear system of the distal neck housing results in rotation of the end effector relative to the shaft assembly.   The distal neck housing non-rotatably and slidably supports a lock collar gear, the lock collar gear being configured such that the first output force of the at least one gear system of the distal neck housing is the end. The first output force of the at least one gear system of the distal neck housing includes a first position that results in firing of an effector, resulting in rotation of the end effector relative to the shaft assembly. The electromechanical surgical system described. The distal neck housing is
An outer tubular housing defining at least one tooth extending radially inward from the outer tubular housing;
A first gear system supported within the outer tubular housing, the first gear system comprising:
A first sun gear that is drivable by the one rotatable drive member of the surgical instrument;
A ring gear rotatably supported in the outer tubular housing;
At least one first planetary gear positioned between the first sun gear and the ring gear and interengaging the first sun gear and the ring gear;
A carrier rotatably supported within the outer tubular housing, the carrier comprising:
Including a respective stem rotatably supporting each first planetary gear;
In one mode of operation, when the first sun gear is rotated, each first planetary gear is turned around the central axis of the first sun gear, resulting in the firing of the end effector,
In another mode of operation, when the first sun gear is rotated, each first planetary gear is rotated about the respective axis of rotation of each first planetary gear, and the rotation of the end effector Bring the
The electromechanical surgical system according to claim 4. The distal neck housing is
A crown gear non-rotatably connected to the carrier;
A locking collar gear supported within the outer tubular housing in a non-rotatable and slidable manner with respect to the shaft;
The lock collar gear includes a first position where the lock collar gear engages the crown gear and prevents the crown gear from rotating; non-rotation of the crown gear prevents rotation of the end effector. Enable
The locking collar gear includes a second position that allows the locking collar gear to be disengaged from the crown gear and allowing the crown gear to rotate, the rotation of the crown gear being the firing of the end effector. Enable,
The electromechanical surgical system according to claim 5. The distal neck housing is
A rotating hub non-rotatably supported in the outer tubular housing;
A second gear system supported in the rotating hub, the second gear system comprising:
A second sun gear non-rotatably connected to the carrier;
At least one second planetary gear rotatably supported in the rotating hub and interengaged with the second sun gear;
A firing connector connected to one of the at least one second planetary gear, the firing connector configured to engage a force receiving member of the end effector; Including
When the carrier rotates, the second sun gear is rotated to rotate the at least one second planetary gear to fire the end effector.
The electromechanical surgical system according to claim 6.   The distal neck housing includes a first clutch mechanism that is disposed between the lock collar gear and the crown gear when the lock collar gear is in the first position. The electromechanical surgical system of claim 6, wherein the lock collar gear and the crown gear are interconnected.   The distal neck housing includes a second clutch mechanism that is disposed between the lock collar gear and the first ring gear when the lock collar gear is in the second position. 9. The electromechanical surgical system of claim 8, wherein the electromechanical surgical system is interposed between and interconnects the locking collar gear and the first ring gear.   At least one of the first clutch mechanism and the second clutch mechanism is respectively disposed between the lock collar gear and the crown gear and between the lock collar gear and the first ring gear. The electromechanical surgical system according to claim 9, comprising a friction enhancing material. The surgical instrument held by the hand
At least one drive motor supported in the instrument housing, wherein the at least one drive motor is configured to rotate the at least one rotatable drive member; ,
A battery disposed within the instrument housing to supply power to the at least one drive motor;
The electromechanical surgical system of claim 1, further comprising: a circuit board disposed within the instrument housing to control power delivered from the battery to the motor. The end effector is
An upper jaw and a lower jaw, wherein at least one of the upper jaw and the lower jaw is movable with respect to the other of the upper jaw and the lower jaw.
The electromechanical surgical system according to claim 1.   The electromechanical surgical system of claim 12, further comprising at least one surgical buttress releasably secured to at least one tissue contacting surface of the upper jaw and the lower jaw.   The electromechanical surgical system according to claim 12, further comprising a drive beam translatable through at least one of the upper jaw and the lower jaw to move the lower jaw relative to the upper jaw. The end effector is
An upper jaw and a lower jaw, wherein at least one of the upper jaw and the lower jaw is movable relative to the other of the upper jaw and the lower jaw; and
A cartridge assembly supported within the lower jaw, the cartridge assembly including a plurality of staples therein;
At least one surgical buttress releasably secured to a tissue contacting surface of at least one of the upper jaw and the lower jaw, wherein the at least one surgical buttress is coupled to the upper jaw and the At least one surgical buttress secured to the at least one of the lower jaws, the upper jaw and the at least one of the lower jaws configured to receive a portion of the at least one suture; The electromechanical surgical system of claim 11, comprising: The lower jaw of the end effector is configured to selectively receive a cartridge assembly, the cartridge assembly comprising:
A cartridge body defining a longitudinally extending knife slot;
A plurality of staples disposed within individual staple retaining slots formed within the cartridge body, wherein the staple retaining slots are a plurality of longitudinally extending rows disposed on opposite sides of the knife slot. A plurality of staples disposed in the
An activation sled slidably supported within the cartridge body, the activation sled being at least one of the plurality of staples from the cartridge body upon distal movement of the activation sled from a proximal position; An activation sled configured to discharge a portion;
A knife sled slidably supported within the cartridge body at a location proximal to the activation sled, the knife sled comprising a knife blade extending into the knife slot;
The drive beam engages the knife sled and the activation sled when the cartridge assembly is disposed in the lower jaw and the drive beam is advanced;
The electromechanical surgical system according to claim 15.   The electromechanical surgical system of claim 16, wherein the activation sled of the cartridge assembly remains in a distally advanced position after any retraction of the drive beam.   The knife sled of the cartridge assembly includes a lockout spring extending from the knife sled, the lockout spring of the knife sled engaging a lockout notch defined in the cartridge body, The electromechanical surgical system of claim 16, wherein the knife sled is prevented from advancing.   19. The activation sled prevents the engagement of the knife sled with the lockout notch of the cartridge body of the lockout spring when the activation sled and the knife sled are in a proximal position. The electromechanical surgical system described.   The electromechanical surgical system of claim 19, wherein the knife sled of the cartridge assembly is retracted upon every retraction of the drive beam.

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